How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Facility | None | $7.41 | $7.41 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $7.41 Typical High $7.41 | Professional | None | $5.75 | $7.41 | $7.41 |
Anthem BCBS Setting Facility Modifier None Typical Low $14.45 Median $15.85 Typical High $43.65 | Facility | None | $14.45 | $15.85 | $43.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.37 Median $6.92 Typical High $14.45 | Professional | None | $4.37 | $6.92 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
Denver HMP Setting Facility Modifier None Typical Low $3.55 Median $7.41 Typical High $16.60 | Facility | None | $3.55 | $7.41 | $16.60 |
Denver HMP Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $11.22 Median $19.50 Typical High $30.20 | Professional | None | $11.22 | $19.50 | $30.20 |
Select Health Setting Facility Modifier None Typical Low $15.14 Median $27.54 Typical High $31.62 | Facility | None | $15.14 | $27.54 | $31.62 |
Select Health Setting Professional Modifier None Typical Low $10.47 Median $15.14 Typical High $20.89 | Professional | None | $10.47 | $15.14 | $20.89 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $7.94 | Facility | None | $6.31 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $8.51 | Professional | None | $5.01 | $5.50 | $8.51 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.16 Median $3.72 Typical High $3.72 | Professional | 52 · Reduced service | $3.16 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.26 Median $1.48 Typical High $1.48 | Professional | 53 · Discontinued | $1.26 | $1.48 | $1.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.12 Typical High $1.12 | Professional | 55 · Aftercare only | $0.95 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.63 Median $0.74 Typical High $0.74 | Professional | 56 · Pre-op care only | $0.63 | $0.74 | $0.74 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $6.92 Typical High $6.92 | Professional | RR · Rental | $0.68 | $6.92 | $6.92 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | UE · Used equipment | $5.01 | $5.01 | $5.01 |
Where Colorado sits
The same service costs 3.5 times more in Montana than in Kansas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Colorado· 27th of 51
$7.41
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.